Citation Nr: 21062734 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 14-08 482 DATE: October 12, 2021 REMANDED 1. Entitlement to service connection for a right foot disability, other than right foot sprain, metatarsalgia, hammer toes, pes cavus, and tenosynitis, claimed as shin splints, is remanded. 2. Entitlement to service connection for a gastrointestinal (GI) disability is remanded. 3. Entitlement to a rating in excess of 10 percent for left eye detached retina residuals, to include pigmentary dispersion syndrome and ptosis, is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty for 21 years, including from August 1992 to July 2012. In March 2015, a videoconference hearing was held before the undersigned; a transcript is in the record. In June 2015 and May 2019, the matters were remanded for additional development. 1., 2., 3. Entitlement to service connection for a right foot disability, other than right foot sprain, metatarsalgia, hammer toes, pes cavus, and tenosynitis, claimed as shin splints and for a gastrointestinal (GI) disability and to a rating in excess of 10 percent for left eye detached retina residuals, to include pigmentary dispersion syndrome and ptosis. In the previous [May 2019] remand, the Board noted that further development of the record was required for each of the matters on appeal, and instructed the AOJ to arrange for examinations to secure adequate medical opinions regarding the etiology of the claimed right foot and GI disabilities. The AOJ arranged for the Veteran to be examined in February 2020. He was sent notice of the scheduled examinations (apparently to a no longer current address); he did not report for the scheduled examinations. However, the claims file includes several items of "Returned Mail" from the Eagle River, Alaska address to which the exam notifications were sent, and the Veteran appears to have moved during the approximate timeframe of the missed examination appointments. In September 2021, he confirmed that he lives in Anchorage, Alaska and will attend any available appointment for examinations. The Board cannot make a fully-informed decision on the service connection issues on appeal because the opinions sought have not been secured. As the Veteran's relocation(s) have been interpreted as non-responsiveness to appearing for scheduled examinations, and he appears to not have been adequately notified, and has affirmatively expressed willingness to appear, he must be afforded further opportunity to attend examinations scheduled for him near his current residence in Anchorage. Further, the Board's previous remand instructed that the claim for an increased rating for left eye detached retina residuals is to be readjudicated following the adjudication of the issue (raised by the record) of entitlement to service connection for a right eye disability, with which the increased rating claim is inextricably intertwined. A decision on entitlement to compensation for right eye detached retina was most recently [in August 2021] deferred for additional development. Therefore, consideration of the left eye rating issue must also again be deferred. The matters are REMANDED for the following: 1. All notices of examinations scheduled for the Veteran should be documented in the record (with identification of the address to which they were sent). 2. Arrange for the Veteran to be examined by an orthopedist to determine the nature and likely etiology of any current right foot disability, other than sprain, metatarsalgia, hammer toes, pes cavus, and tenosynitis (claimed as shin splints). The Veteran's claims file must be reviewed by the examiner in conjunction with the examinations. All indicated test and studies should be completed. All relevant diagnoses should be noted, and there should be an opinion regarding etiology of each diagnosed entity, whether it is as likely as not (a 50 percent or greater probability) that the diagnosed disability is etiologically related to the Veteran's service. Regarding any arthritis shown by X-ray, indicate whether it is a residual of fracture/injury in service or is otherwise related to service. If not, but is found to be wholly due to postservice aging, include rationale for such conclusion. A thorough rationale should accompany all opinions. 3. Arrange for the Veteran to be examined by an appropriate clinician (e.g., in digestive disorders) to determine the nature and likely etiology of any current GI disability. The Veteran's claims file must be reviewed by the examiner in conjunction with the examination. All indicated tests or studies should be completed. All GI diagnoses should be noted. The examiner should specifically consider and discuss the October 2015 examination finding of diarrhea, which required additional testing and workup to arrive at a diagnosis and treatment, to include doing any testing necessary. The examiner should offer an opinion regarding the etiology of each GI disability entity diagnosed, indicating whether it is at least as likely as not (a 50 percent or greater probability) that it is etiologically related to the Veteran's service. A thorough rationale should accompany all opinions. 4. After the issue of service connection for a right eye disability is decided, and following any further development indicated, readjudicate the claim for an increased rating for residuals of a left eye retinal detachment considering the determination made on the service connection for a right eye disability claim. Advise the Veteran that the issue of service connection for a right eye disability will be before the Board only if he perfects an appeal of a negative determination on that claim. GEORGE R. SENYK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Schechner, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.